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Abstract Background This study aims to assess the sustained immunological response to the SARS-CoV-2 vaccine in patients with autoimmune inflammatory rheumatic diseases (AIRD) undergoing different treatment regimens. Methods We conducted a prospective observational study involving 157 AIRD patients without prior COVID-19 infection. Treatment regimens included non-treatment or glucocorticoid-only (not-treated/GCs), non-biological drugs, biological therapy, and JAK inhibitors. All participants completed the two-dose vaccine schedule, and 110 of them received an additional booster dose. Serum samples were collected approximately 3–6 months after the second and third vaccine doses to measure antibodies against the Spike protein (antiS-AB) and neutralizing antibodies (nAB) targeting six SARS-CoV-2 variants. Results Following the third dose, all patients exhibited a significant increase in antiS-AB (FC = 15, p

Abstract Background Despite existing extensive literature, a comprehensive and clinically relevant classification system for osteoarthritis (OA) has yet to be established. In this study, we aimed to further characterize four knee OA (KOA) inflammatory phenotypes (KOIP) recently proposed by our group, by identifying the inflammatory factors associated with KOA severity and progression in a phenotype-specific manner. Methods We performed an analysis within each of the previously defined four KOIP groups, to assess the association between KOA severity and progression and a panel of 13 cytokines evaluated in the plasma and synovial fluid of our cohort’s patients. The cohort included 168 symptomatic female KOA patients with persistent joint effusion. Results Overall, our analyses showed that associations with KOA outcomes were of higher magnitude within the KOIP groups than for the overall patient series (all p-values < 1.30e−16) and that several of the cytokines showed a KOIP-specific behaviour regarding their associations with KOA outcomes. Conclusion Our study adds further evidence supporting KOA as a multifaceted syndrome composed of multiple phenotypes with differing pathophysiological pathways, providing an explanation for inconsistencies between previous studies focussed on the role of cytokines in OA and the lack of translational results to date. Our findings also highlight the potential clinical benefits of accurately phenotyping KOA patients, including improved patient stratification, tailored therapies, and the discovery of novel treatments.

Objective To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort.Methods We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review. Performance was analysed using the C-statistic and the area under the receiver operating characteristic curve (AUROC). Internal validation was carried out using a 100-sample bootstrapping procedure. ORs were transformed into score items, and the AUROC was used to determine performance.Results A total of 1459 patients who had completed 1 year of follow-up were included in the development cohort (mean age, 49±13 years; 90% women). Twenty-five (1.7%) had experienced ≥1 severe infection. According to the adjusted multivariate model, severe infection could be predicted from four variables: age (years) ≥60, previous SLE-related hospitalisation, previous serious infection and glucocorticoid dose. A score was built from the best model, taking values from 0 to 17. The AUROC was 0.861 (0.777–0.946). The cut-off chosen was ≥6, which exhibited an accuracy of 85.9% and a positive likelihood ratio of 5.48.Conclusions SLESIS-R is an accurate and feasible instrument for predicting infections in patients with SLE. SLESIS-R could help to make informed decisions on the use of immunosuppressants and the implementation of preventive measures.

Abstract Limited data exists on SARS-CoV-2 sustained-response to vaccine in patients with rheumatic diseases. This study aims to evaluate neutralizing antibodies (nAB) induced by SARS-CoV-2 vaccine after 3 to 6 months from administration in Systemic Lupus Erythematosus (SLE) patients, as a surrogate of sustained-immunological response. This cross-sectional study compared nAB titre of 39 SLE patients and 37 Healthy individuals with no previous SARS-CoV-2 infection, who had all received a complete regimen of a mRNA SARS-CoV-2 vaccine within the last 3 to 6 months. We included four lines of SLE treatment including Not-treated, Hydroxychloroquine, immunosuppressive drugs and biological therapy. Glucocorticoids were allowed in all groups. Healthy and Not-treated individuals showed the highest levels of nAB. Treated patients presented lower nAB titres compared to Healthy: a 73% decrease for First-Line patients, 56% for Second-Line treatment and 72% for Third-Line. A multivariate analysis pointed to Glucocorticoids as the most associated factor with declining nAB levels (75% decrease) in treated SLE. Furthermore, a significant reduction in nAB titres was observed for Rituximab-users compared to Healthy subjects (89% decrease). Medium-term response of SLE patients to SARS-CoV-2 mRNA vaccines is negatively impacted in Glucocorticoids and Rituximab users. These findings might help to inform recommendations in vaccination protocols for SLE patients.

BackgroundAfter the COVID-19 pandemic, society has become more aware of the importance of some basic hygienic habits to avoid exposure to pathogens transmitted via hands. Given that a high frequency of touching mucous membranes can lead to a high risk of infection, it is essential to establish strategies to reduce this behavior as a preventive measure against contagion. This risk can be extrapolated to a multitude of health scenarios and transmission of many infectious diseases. #RedPingüiNO was designed as an intervention to prevent the transmission of SARS-CoV-2 and other pathogens through the reduction of facial self-touches by thoughtfully engaging participants in a serious game. ObjectiveFacial self-touches should be understood as behaviors of limited control and awareness, used to regulate situations of cognitive and emotional demands, or as part of nonverbal communication. The objective of this study was to ensure that participants become aware of and reduce these behaviors through a game of self-perception. MethodsThe quasi-experimental intervention was applied to 103 healthy university students selected by convenience sampling and put into practice for 2 weeks, with 1 control group (n=24, 23.3%) and 2 experimental groups (experimental group with no additional social reinforcement interventions: n=36, 35%; experimental group with additional social reinforcement interventions: n=43, 41.7%). The objective was to improve knowledge and perception and reduce facial self-touches to prevent exposure to pathogens transmitted via hands not only in health multihazard scenarios but also in ordinary circumstances. The ad hoc instrument used to analyze the experience consisted of 43 items and was valid and reliable for the purpose of this study. The items were divided into 5 blocks extracted from the theoretical framework: sociological issues (1-5); hygiene habits (6-13); risk awareness (14-19); strategies for not touching the face (20-26); and questions after the intervention (27-42), designed as a postintervention tool assessing the game experience. Validation of the content was achieved through assessment by 12 expert referees. External validation was performed using a test-retest procedure, and reliability was verified using the Spearman correlation. ResultsThe results of the ad hoc questionnaire, which were analyzed using the Wilcoxon signed-rank test and McNemar index to identify significant differences between test and retest for a 95% CI, showed that facial self-touches were reduced (item 20, P

Purpose: The purpose of this study is to assess the prevalence of osteoporosis and fragility fractures in patients with liver cirrhosis (LC) and determine the associated risk factors, evaluating the usefulness of FRAX® as a screening method to identify patients at a higher risk of fracture. Methods: This was a cross-sectional study. Demographic, clinical, and analytical data were collected in a randomized sample of LC patients attending the Hepatology Department of a university hospital. We assessed the absolute risk of fracture at 10 years (FRAX®) and based on the bone mineral density (BMD), the presence of morphometric vertebral fracture with a vertebral fracture assessment (VFA), or a thoracic and lumbar X-ray and bone microarchitecture with a trabecular bone score (TBS). Results: Ninety-two patients were included (71% male); the mean age was 63 ± 11.3 years. The main etiology of LC was alcoholism (52.2%), and most patients were Child–Pugh A (80.4%), with a mean model for end-stage liver disease (MELD) score of 10.1 ± 3.6. Sixteen patients (17.4%) had osteoporosis, and fifty-four (58.7%) had osteopenia. Eight patients (8.7%) had suffered at least one fragility fracture. The absolute risk of a major fracture according to FRAX without the BMD was 5.7 ± 4.5%. Risk factors associated with osteoporosis were age and the female sex. BMI > 30 was a protective factor. A FRAX cut-off point for a major fracture > 6.6% had a sensitivity of 69% and a specificity of 85% for a diagnosis of osteoporosis. Conclusions: The prevalence of osteoporosis and fractures in patients with LC is high, particularly in older women. FRAX® may be a useful method to identify candidates for bone densitometry. A FRAX value below 6.6% without the BMD can avoid unnecessary testing.

Abstract COVID-19 pathophysiology is currently not fully understood, reliable prognostic factors remain elusive, and few specific therapeutic strategies have been proposed. In this scenario, availability of biomarkers is a priority. MS-based Proteomics techniques were used to profile the proteome of 81 plasma samples extracted in four consecutive days from 23 hospitalized COVID-19 associated pneumonia patients. Samples from 10 subjects that reached a critical condition during their hospital stay and 10 matched non-severe controls were drawn before the administration of any COVID-19 specific treatment and used to identify potential biomarkers of COVID-19 prognosis. Additionally, we compared the proteome of five patients before and after glucocorticoids and tocilizumab treatment, to assess the changes induced by the therapy on our selected candidates. Forty-two proteins were differentially expressed between patients' evolution groups at 10% FDR. Twelve proteins showed lower levels in critical patients (fold-changes 1.20–3.58), of which OAS3 and COG5 found their expression increased after COVID-19 specific therapy. Most of the 30 proteins over-expressed in critical patients (fold-changes 1.17–4.43) were linked to inflammation, coagulation, lipids metabolism, complement or immunoglobulins, and a third of them decreased their expression after treatment. We propose a set of candidate proteins for biomarkers of COVID-19 prognosis at the time of hospital admission. The study design employed is distinctive from previous works and aimed to optimize the chances of the candidates to be validated in confirmatory studies and, eventually, to play a useful role in the clinical practice.

Background: Acute anterior uveitis (AAU) is the most frequent extra-musculoskeletal manifestation in spondyloarhtritis (SpA). Previous data on AAU focused on axial disease; therefore, it is not well known whether the clinical characteristics of patients with AAU and recurrent AAU differ between patients with axial and peripheral SpA. Objective: Primary objective was to compare the clinical characteristics of patients with AAU from patients without AAU in axial and peripheral spondyloarthritis (SpA) patients. Secondary objectives were to describe the clinical features of patients with AAU in the subset of patients with peripheral SpA (pSpA) and the clinical characteristics of patients with recurrent AAU in SpA patients. Design: This is an ancillary analysis of the ASAS-PerSpA study which included 3152 patients, 2719 patients with axSpA and 433 with pSpA according to rheumatologist judgement. Methods: Recurrent AAU was defined as the presence of two or more episodes of AAU ever. Univariable and multivariable binary logistic regression analyses were conducted to identify factors associated with the presence of AAU ever and the presence of recurrent AAU. Results: Overall, 663 patients (21%) presented AAU. Of them, 444 (66.9%) presented recurrent episodes. In patients with SpA, HLA-B27 positivity is the most important factor linked to the presence of AAU, odds ratio (OR) = 2.70 (95% CI = 2.04–3.6). In patients with pSpA, HLA-B27 positivity was also the most relevant factor linked to the presence of AAU, OR = 6.08 (95% CI = 2.72–15.68). Moreover, disease duration, younger age and higher body mass index (BMI) were the only factors slightly linked to the presence of recurrent episodes, OR = 1.03 (95% CI = 1.01–1.04), OR = 1.01 (95% CI = 1.00–1.03) and OR = 1.04 (95% CI = 1.01–1.08), respectively. Conclusion: HLA-B27 positivity is the most relevant factor linked to AAU risk in SpA patients, and this association is even stronger in those patients with pSpA. Moreover, our study did not find an association between HLA-B27 positivity and recurrent AAU in SpA patients.

Abstract Objective To assess HLA-B27 influence on the clinical phenotype of Ankylosing Spondylitis (AS) patients. Method An observational, cross-sectional and descriptive study of AS patients from the Spanish REGISPONSER database was performed. Demographic, clinical, disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP)), and radiographic data (Bath Ankylosing Spondylitis Radiology Index (BASRI) score) were compared regarding HLA-B27 status. A univariate and multivariate analysis was performed to identify variables independently related to the presence of HLA-B27. Results Data from 1235 patients (74.8% male) were analyzed; 1029 were HLA-B27 positive (83%). HLA-B27-positive patients showed higher family aggregation and an earlier onset of disease compared with those who were HLA-B27 negative. HLA-B27-negative patients presented statistically higher BASDAI and BASFI scores and higher prevalence of arthritis, dactylitis, and extra-articular manifestations (psoriasis and inflammatory bowel disease (IBD)) but not anytime uveitis compared with those who were HLA-B27 positive. In the multivariate analysis, family history (odds ratio (OR) 2.10, 95% confidence interval (CI) 1.27–3.49), younger age at diagnosis (OR 0.97, 95% CI 0.96–0.98), presence of peripheral arthritis (OR 0.53, 95% CI 0.32–0.89), dactylitis (OR 0.16, 95% CI 0.05–0.56), psoriasis (OR 0.45, 95% CI 0.26–0.78), and IBD (OR 0.22, 95% CI 0.12–0.40) were the main variables independently related to the presence or not of HLA-B27. Conclusion In Caucasian AS patients, the presence of HLA-B27 is related to an earlier disease onset and higher family aggregation. Absence of HLA-B27 is related to a higher frequency of peripheral arthritis, dactylitis, and extra-articular manifestations. Being HLAB27 positive is not related to a higher burden of disease or anytime uveitis.

An amendment to this paper has been published and can be accessed via the original article.

La promoción de la actividad física en el lugar de trabajo forma parte de las estrategias globales para la promoció de la salud. La implantación de programas de actividad física en el entorno laboral requiere de un análisis de la demanda existente en contextos específicos. En este estudio se analiza la demanda de actividad física entre los trabajadores de dos mercados madrileños: "Maravillas" y "Las Águilas". Se plantea la hipótesis de que en los mercados estudiados predomina la demanda latente (personas que no realizan actividad física pero que desearían hacerla) sobre la demanda establecida (personas que realizan actividad física) y la demanda ausente (personas que no realizan actividad física pero que no desean hacerla). Los resultados muestran que esta hipótesis se cumple en el mercado de "Maravillas", en el que las diferencias significativas en la distribución de los porcentajes se inclinan a favor de la demanda latente (48%). En cambio, en el mercado de "Las Águilas" no existe una diferencia significativa entre los distintos tipos de demanda, si bien el principal porcentaje de la demanda es latente (39,5%). Las principales implicaciones de este estudio son la constatación de la existencia de una demanda potencial de programas de actividad física entre los trabajadores de los mercados estudiados,así como la recomendación de ubicar la primera experiencia piloto en el mercado de Maravillas, dirigiéndola principalmente a mujeres de 30 a 39 años.

El objetivo general de esta investigación es conocer, desde una perspectiva social y organizativa, las fundaciones españolas que tienen afectado su patrimonio a fines de interés general concretamente en el ámbito de la actividad física y el deporte, contribuyendo, en su caso, al debate social y científico sobre su papel, características y perspectivas en el futuro. No hemos hallado estudios realizados sobre fundaciones deportivas españolas. En definitiva, no conocemos cuántas y cuáles son, cómo operan, dónde realizan su labor, para quién la realizan y con qué recursos cuentan. Más aún, se echa en falta un marco científico sólido sobre el marco institucional del deporte y sus organizaciones. Por la ausencia de estas investigaciones nos enfrentaríamos a un campo desconocido sino fuera porque sí que existen algunos estudios realizados sobre fundaciones en general y sobre grupos sectoriales. Para abordar el objeto de estudio, nos hemos apoyado en estos trabajos en gran medida. En consecuencia, los objetivos específicos de la investigación han sido crear una base de datos documental de fundaciones deportivas españolas, que sea valiosa, utilizable y que permita su actualización; describir las principales características de las fundaciones deportivas españolas; y conocer si existen diferencias significativas entre fundaciones deportivas en base a las características descriptivas de las mismas. El diseño metodológico creado para abordar los objetivos y verificar las hipótesis planteadas se ha basado en un análisis de documentos y en una encuesta elaborada para este trabajo. El análisis de contenido, el estadístico y su posterior interpretación, nos han permitido medir las variables, alcanzar los objetivos y comprobar las hipótesis. En definitiva, las fundaciones deportivas españolas, con sólo algo más de veinte años de vida, se pueden considerar de reciente creación. Su ritmo de crecimiento ha ido aumentando en gran medida, contando en 2004, con 180 fundaciones deportivas identificadas y recogidas en un inventario elaborado para este trabajo. Estas organizaciones son principalmente prestadoras de servicios, operan en el ámbito autonómico y dirigen sus actividades principalmente a los jóvenes, la infancia y los deportistas. Los objetivos que marcan los estatutos de estas fundaciones son el fomento del deporte en general o de una disciplina en concreto sin especificar, en la mayoría de los casos, en que ámbito concreto actúan del interés general en el deporte. Las fundaciones deportivas son entidades cada vez más profesionalizadas, al contar con personal remunerado además de voluntario, aunque no tanto como el conjunto de las fundaciones en general. La vía de financiación más utilizada se corresponde principalmente con los fondos propios (patrocinio, venta de bienes y servicios, etc.). Por último, señalar que existen muchas fundaciones deportivas que manejan reducidos presupuestos y pocas fundaciones que gestionan grandes presupuestos.

El objetivo general de esta investigación es conocer, desde una perspectiva social y organizativa, las fundaciones españolas que tienen afectado su patrimonio a fines de interés general, concretamente en el ámbito de la actividad física y el deporte, contribuyendo, en su caso, al debate social y científico sobre su papel, características y perspectivas en el futuro. No hemos hallado estudios realizados sobre fundaciones deportivas españolas. En definitiva, no conocemos cuántas y cuáles son, cómo operan, dónde realizan su labor, para quién la realizan y con qué recursos cuentan. Más aún, se echa en falta un marco científico sólido sobre el marco institucional del deporte y sus organizaciones. Por la ausencia de estas investigaciones nos enfrentaríamos a un campo desconocido si no fuera porque sí que existen algunos estudios realizados sobre fundaciones en general y sobre grupos sectoriales. Para abordar el objeto de estudio, nos hemos apoyado en estos trabajos en gran medida. En consecuencia, los objetivos específicos de la investigación han sido crear una base de datos documental de fundaciones deportivas españolas, que sea valiosa, utilizable y que permita su actualización; describir las principales características de las fundaciones deportivas españolas; y conocer si existen diferencias significativas entre fundaciones deportivas en base a las características descriptivas de las mismas. El diseño metodológico creado para abordar los objetivos y verificar las hipótesis planteadas se ha basado en un análisis de documentos y en una encuesta elaborada para este trabajo. El análisis de contenido, el estadístico y su posterior interpretación, nos han permitido medir las variables, alcanzar los objetivos y comprobar las hipótesis. En definitiva, las fundaciones deportivas españolas, con sólo algo más de veinte años de vida, se pueden considerar de reciente creación. Su ritmo de crecimiento ha ido aumentando en gran medida, contando en 2004 con 180 fundaciones deportivas identificadas y recogidas en un inventario elaborado para este trabajo. Estas organizaciones son principalmente prestadoras de servicios, operan en el ámbito autonómico y dirigen sus actividades principalmente a los jóvenes, la infancia y los deportistas. Los objetivos que marcan los estatutos de estas fundaciones son el fomento del deporte en general o de una disciplina en concreto sin especificar, en la mayoría de los casos, en que ámbito concreto, actúan del interés general en el deporte. Las fundaciones deportivas son entidades cada vez más profesionalizadas, al contar con personal remunerado además de voluntario, aunque no tanto como el conjunto de las fundaciones en general. La vía de financiación más utilizada se corresponde principalmente con los fondos propios (patrocinio, venta de bienes y servicios, etc.). Por último, señalar que existen muchas fundaciones deportivas que manejan reducidos presupuestos y pocas fundaciones que gestionan grandes presupuestos.

Objectives To describe and compare the prevalence of comorbidities in female and male patients with spondyloarthritis (SpA) and to assess whether comorbidities had a different impact on disease outcomes in male and female patients.Methods This is a post hoc analysis of the COMOrbidities in SPondyloArthritis study. Differences in comorbidities regarding sex were assessed using logistic regression models. Comorbidities were evaluated for their impact on disease outcomes (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index, European health-related quality of life questionnaire) with linear models, which included sex and comorbidity as explanatory variables and their interaction. Age and treatment with biological synthetic disease-modifying antirheumatic drugs were included as confounders.Results We included 3982 patients with SpA (65% male, mean age 43.6 years). Male and female patients with SpA exhibited similar comorbidity profiles, except for a low prevalence of fibromyalgia in males and a higher prevalence of certain cardiovascular risk factors in males (hypertension, dyslipidaemia, renal impairment and ischaemic heart disease). Comorbidities, especially fibromyalgia, correlated with higher disease activity, decreased physical function and reduced health-related quality of life in both sexes. Some comorbidities exhibited sex-specific associations with disease outcomes. Peptic ulcers and high waist circumference had a greater impact on disease activity in females (with a higher impact in BASDAI than in ASDAS). In contrast, osteoporosis had a more pronounced effect on physical function in male patients.Conclusions Comorbidities exert distinct influences on disease activity, physical function and health-related quality of life in male and female patients with SpA. Understanding these sex-specific effects is crucial for improving SpA management, emphasising the importance of assessing disease activity using ASDAS when comorbidities are present to mitigate sex-related disparities in disease assessment.

Salmon aquaculture is constantly threatened by pathogens that impact fish health, welfare, and productivity, including the sea louse Caligus rogercresseyi. This marine ectoparasite is mainly controlled through delousing drug treatments that have lost efficacy. Therein, strategies such as salmon breeding selection represent a sustainable alternative to produce fish with resistance to sea lice. This study explored the whole-transcriptome changes in Atlantic salmon families with contrasting resistance phenotypes against lice infestation. In total, 121 Atlantic salmon families were challenged with 35 copepodites per fish and ranked after 14 infestation days. Skin and head kidney tissue from the top two lowest (R) and highest (S) infested families were sequenced by the Illumina platform. Genome-scale transcriptome analysis showed different expression profiles between the phenotypes. Significant differences in chromosome modulation between the R and S families were observed in skin tissue. Notably, the upregulation of genes associated with tissue repairs, such as collagen and myosin, was found in R families. Furthermore, skin tissue of resistant families showed the highest number of genes associated with molecular functions such as ion binding, transferase, and cytokine activity, compared with the susceptible. Interestingly, lncRNAs differentially modulated in the R/S families are located near genes associated with immune response, which are upregulated in the R family. Finally, SNPs variations were identified in both salmon families, where the resistant ones showed the highest number of SNPs variations. Remarkably, among the genes with SPNs, genes associated with the tissue repair process were identified. This study reported Atlantic salmon chromosome regions exclusively expressed in R or S Atlantic salmon families’ phenotypes. Furthermore, due to the presence of SNPs and high expression of tissue repair genes in the resistant families, it is possible to suggest mucosal immune activation associated with the Atlantic salmon resistance to sea louse infestation.

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